Inspection on 24/09/08 for Cosy Lodge

This inspection was carried out on 24th September 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cosy Lodge 04/10/06

Cosy Lodge 03/01/06

Cosy Lodge 07/07/05

Cosy Lodge 01/02/05

Cosy Lodge 27/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 01/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cosy Lodge Westwell Leacon Charing Ashford Kent TN27 0EH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary Cochrane     Date: 2 4 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Cosy Lodge Westwell Leacon Charing Ashford Kent TN27 0EH 01233713515 Telephone number: Fax number: Email address: Provider web address: cosylodge@counticare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Peter Mark Sell Type of registration: Number of places registered: Counticare Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Cosy Lodge is a detached chalet style property situated in a rural setting to the edge of Westwell Leacon on the outskirts of Ashford. Caretech are the registered owners and have a number of other services in Kent. Cosy Lodge is registered to provide accommodation, personal care and support for up to six adults with learning disabilities. Vehicles are available to use. To the front of the property there is gated access leading to parking for up to four cars. Cosy Lodge is on two levels. On the ground floor there are two bedrooms, lounge, dining room, office, kitchen, laundry Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home room and staff toilet/shower room. There are four further bedrooms and two bathrooms on the first floor. There are secure gardens to the rear of the property. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The last inspection on this service was completed on 4th October 2006. This visit to the service was an unannounced Key Inspection which took place over one day. The registered manager was on holiday and the deputy was a day off. We were assisted by the senior team leader and also met with the area manager. The people living at the home and the staff on duty were helpful and co-operative throughout the visit. Care Homes for Adults (18-65 years) Page 6 of 30 The visit included talking with people living in the home and the care staff. General observations were made during the day of how people are supported. We had a look around the home and various records were inspected. We observed how staff supported service users during social activities and when offering care. We looked at and discussed service users individual support plans and their risk assessments and saw some polices. We also looked at staff training records and the homes quality assurance. An annual service assurance assessment (AQAA) was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. Information received from the home since the last inspection was used in the report. We also took into account the things that have happened in the service, these are called notifications and are a legal requirement. The fees for this service range between 1,265.93 and 1,587.50 with additional charges for hairdressing, magazines and newspapers. What the care home does well: What has improved since the last inspection? What they could do better: The service needs to make sure that care plans are updated when the needs of a service users change. This will make sure that everyone is aware of the changes to care and information does not get lost. All of the plans and risk assessments need to be individualised so they met the personal needs of the service users. The home needs to recruit a permanent staff team so the service users get to know the staff and who is going to be supporting them. This will make sure that there is a consistent and planned approach to the support and care. There needs to be an on-going maintenance and refurbishment plan in place with time scales so work can be planned and the home maintained to good standard. Care Homes for Adults (18-65 years) Page 8 of 30 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users know that the home will be able to meet their assessed needs and aspirations. Service users know what they are paying for and their places at the home are protected. Evidence: The manager has just updated the homes statement of purpose and service users guide. Each person living at the home will receive a service users guide that has been personalised. The guide is easy to read and is pictorial. It contains all the information needed to let people know what the home has to offer. There is information on activities and how staff will help. It explains about support plans, laundry and catering. There is also a picture of peoples key workers and how to make a complaint. Information is also written in symbol form. Each guide also explains terms and conditions and a contract. They include information on the fees that are charged by the company. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: There have been no new admissions to the home since the last key unannounced inspection in October 2006. Since this time a new company is providing the service. The staff told us that thorough pre-assessments would be done before any new person came to live at the home. This would ensure that the home has the facilities, skills and resources to support and care for the person in the best possible way. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have individual care and support plans that identify their needs and personal goals. They are supported in taking risks as part of an independent lifestyle. Evidence: All of the people living at the home have a support/care plan. We looked closely at 2 of the plans. They covered all aspects of health and social care, medical needs, specialised needs, behaviour management, interventions, and nutritional information. The majority of the care plans are person centred and are easy to understand, follow and cross reference. They had references to equality and diversity issues. They explained in detail how to support and care for the person in the way they preferred. Likes and dislikes are included and there are profiles in place on how people prefer to communicate. We did see that the plans on how to manage behaviours with interventions was more or less the same for each person. This area of the care plans need to be individualised to make sure that each person is supported in the way that best suits them while keeping them safe and protecting staff and others .The area Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: manager of the service had also identified this short fall during her monthly regulation 26 visit. We did see that a health care need of a service user involving medication had recently been reviewed and changed. The care plan had not been up-dated to reflect this change. The information had been recorded in the staff communication book. This means service user may not received the care that he needed and the information may have been lost. The area manager said this would be addressed. The plans are reviewed monthly. Goals and aspirations for service users are looked at to see if outcomes have been achieved. Service users are involved with reviewing their plans on a monthly basis. Families are involved in the process and there are annual care management reviews. There are risk assessments in place which give information how to keep people as safe as possible while allowing them to be as independent and active. Risk assessments are reviewed monthly. We saw that some of the risk assessments had not been signed and dated. Daily records contain relevant information to show how the residents have made choices and decisions. It was possible to cross reference information The key workers have regular 1 to 1 talk times with service users. These sessions are used to make sure that all the service users are listened to and time is allowed to for them to express how they are feeling. Relevant information from these sessions is used to improve the service and resolve any issues. It was seen that staff listened to what the service users want and act on this. There are regular service users meetings We observed interactions and spoke to staff and service users and we looked at records and documentation. There was evidence to support that people are involved in making decisions on how they live their lives. Any limitations and restrictions are recorded in the individuals care plan. There was evidence available to show how people choose their meals, how they choose what they want to do and where they want to go. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are encouraged and supported to take part in appropriate activities. They are part of the local community. Service users are supported to maintain family contact and assisted to exercise choice over their lives. Nutrition is well managed and a healthy menu is provided. Evidence: Each of the service users has an individual activities programme which has been developed depending on their preferences needs and capabilities. When we visited 3 of the service users were at the companies day centre where they go 2-3 times per week. The staff actively support the service users to be as independent and involved as possible. Service users told us they enjoy going out. One person told us he enjoyed cooking and shopping and there evidence to show he did this regularly. The service Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: users also attend numeracy and literacy classes. The staff said people are supported to developed education skills. People are encouraged and supported to be creative. Service users use the local leisure facilities regularly. They are also part of the local community and use all the local facilities. There are regular trips to the swimming pool, bowling and golf. Everyone went on holiday this year. People we spoke to had a really good time and will be planning to go away again. The service users are encouraged and supported to maintain contact with their family and friends. The service users are involved in the daily routines of the home and are encouraged to take care of their own rooms and are involved in preparing meals and drinks. People can choose when to be in the privacy of their own rooms or in the communal areas. They can choose whether they would like a key to their rooms. Keys are available but we were told that some service users have chosen not to use them. There is evidence in place to support this. Everyone has the freedom to access all communal areas of the home. Members of staff were observed demonstrating good body language and communication skills when interacting with the service users. They were seen to talk and interact in a positive way and involved and included service users in conversations. The home told us they have a set menu but choices are given at every meal time. Mealtimes at the home are flexible. A record is kept of the meals eaten so any problems can be identified quickly and acted on. Service users can use the kitchen whenever they want. They have access to drinks and snacks and assist in preparing and cooking meals. Service users said that they enjoyed their mealtimes and the food is good. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home makes sure that the service users benefit from having their physical and emotional and health needs met. They are given personal support in a way that they prefer and require. Service users are protected by the homes medication policies and procedures for dealing with medicines. Evidence: During the visit we saw and were able to evidence that personal care is delivered in a way that is flexible, reliable and person centred. We saw that life skills and dignity are promoted. The staff were seen to respect the privacy and dignity of the service users allowing them control over their own life. The service operates a key worker system to provide sensitive and individual support to the service users. People choose their own clothes and are supported to shop. Service users and staff told us that support with personal care was offered appropriately and sensitively. There is a flexible approach to daily living activities e.g. getting up, going out, bed, Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: bath and mealtimes. Staff were seen to approach service users in a caring and supportive manner. The home is developing separate health care plans for each person. These have not been fully completed but did contain a lot of the necessary information to make sure that heath care needs are identified monitored and met. Service users health is closely monitored and if any problems arise they are dealt with promptly and appropriately. The health care plans are taken to out-side appointments so they outcomes can be immediately recorded and actioned. Some of the residents have complex health needs. The service was able to evidence that these are well managed. There is information in the plans, which highlights early warning signs of identified health needs, this means staff can take immediate and appropriate action. We did notice that on some occasions the plans contain words which may not be familiar to everyone who reads them. For example when describing a stage of an epileptic fit the word status had been written in the plan. When talking about diabetes the words hypo and hyper had been written and no explanation given as to what these words mean. As previously mentioned the manager needs to make sure that any change in health care is updated in the persons care plan as soon as possible. This will make sure all health needs are identified, met, monitored and reviewed at the required intervals. The service users have access to health care facilities and routine checks are carried out. We saw that health care needs are carefully monitored and there is input from local specialist teams when necessary. The service told us that all service users have had an annual health check from the local GP surgery. A medical report sheet is kept up to date evidence dental, chiropody, G.P. and other health care appointments. The home uses a pre- packed medication system and all staff who administer medication have received appropriate training. A list of staff competent to administer medication is kept. Sample signatures are also available. The medication is stored in a locked cupboard and the keys to this are kept on the person who is in charge of the shift. There are robust protocols in place for medication that is given when required. Medication is reviewed regularly and competencies are checked. At the time of the visit we were told that amemeber of staff had omitted to sign the drug sheet. This error was identified quickly by the area manager and the appropriate action was taken. Care Homes for Adults (18-65 years) Page 18 of 30 Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by an effective complaints procedure. There are systems in place, which protect service users from abuse. Evidence: The home does have an open culture and service users are encouraged to express their views and concerns. Views are sort on a regular basis both in meetings and on a one to one basis. Views are recorded and acted upon. There is a complaints procedure in place, which meets all relevant requirements. There has been one complaint made to the home since the last inspection. This was recorded and actioned appropriately. The changes made as a result to the outcome of the complaint was also recorded. The company provides training for all the staff in safeguarding vulnerable adults. The home has an Adult Protection Policy including whistle blowing. Physical and verbal aggression is monitored and recorded in all areas of care for the service users. There are financial systems in place to record service users monies have recently been reviewed and are now more secure. Any incidents or allegations are reported to social services and the commission. There have been no safeguarding alerts since the last inspection visit. Care Homes for Adults (18-65 years) Page 20 of 30 Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an environment that is appropriate to the needs of the people who live there. On the whole Cosy Lodge s homely, comfortable and safe. Evidence: We looked around the home. We saw that the majority of the home is maintained to a good standard. The lounge and dining room are spacious and homely and provided an environment for people to relax in. The bedrooms we looked at were well decorated and furnished. The kitchen was clean and service user can help themselves to drinks and snacks. The bedrooms that we saw are individual and reflected the personalities of the people who live at the home. There are 2 communal bathrooms in the house. One of the bathrooms did smell musty and damp. Staff told us this was because the window restrictors were not appropriate and the window could not be opened. The flooring in this bathroom was passed its best and was stained. We were not able to see a maintenance and renewal plan so we could not see if these issues are going to be dealt with. The second bathroom has no hot water to the bath. Staff said that was reported some time ago but the issue has not yet been resolved. The service needs to make sure that these environmental issues are dealt with. Both bathrooms could be made more homely and inviting. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The service showed us evidence that monthly safety checks are done. All areas of the environment are looked at. If they are not satisfactory an action plan is developed to address the issue .The service does need to make sure they put time scales on actions so to make sure the work is done in a timely fashion. The monthly visits done by the area manager have identified the need for the home to have a deep clean. We were told this would be done in the near future. The service users with support of the staff have started to plant a vegetable garden. They have also set up a small pond area. There is a laundry room is at the back of the house with appropriate equipment and storage space. We were told that service users are encouraged and supported to do their own washing. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by a competent and qualified staff team and are protected by the homes recruitment procedures. Evidence: The staff reported that they have developed good relationships with the service users and are able to anticipate and meet the individual needs of the client group. There is a key worker system and staff support and communicate with service users in a respectful manner. It was observed that the staff are accessible and approachable. It was evidenced that the staff on duty put the needs of the service users first. They responded positively and openly to staff. Some of the staff have worked at the home for a reasonable length of time and have a good knowledge and understanding of the service users. Service users told us they like the staff and get on well with them. The home has an NVQ programme and has reached the 50 target of staff with NVQ level 2 or above. There are 3 care staff working throughout the day and 2 sleep in staff at night. Some staff said they thought extra staff was needed in the morning when they were busy Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: supporting people to get ready in time for activities. Other staff said they thought there was enough staff at this time. It was evidenced that service users do attend planned daily activities on a regular basis. It was identified and staff told us that sometimes service users are not able to go out in the evenings as they have not got enough drivers within the staff group. At the time of the visit the home employed 6 full time care staff. They are trying to recruit more permanent staff to make sure there is continuity for the service users. They told us because of the location of the home it is hard to recruit and keep staff. At the time of the visit the staff told us that they are using a lot of agency staff to cover shifts especially at weekends when there can be 2 agency staff on a shift. The home does try and use the same agency staff to cover their shortfalls so that the service user know who will be supporting them but this is not always possible. We were unable to see any of the staff files. This was because the registered manager was on holiday and no-one else had access to the staff files. We did speak to a new member of staff who has been working at the home for a week. She told us that all the safety checks were undertaken before she started to work at the home. She said that she filled in an application form which included a full employment history. She told us that she visited the home before starting to make sure the service users had met her. She told us she had a formal interview and was then appointed. The last inspection report and the information on the AQAA told us that thorough recruitment procedures are adhered to. The home has a rolling training programme and most people are up to date. There is a training matrix which shows the training the staff have completed and that which remains outstanding. Gaps have been identified and training planned in both mandatory and specialist training. The home has started a new induction programme which is linked to skill for care. A new staff member was in the process of undertaking the programme. A supervision and appraisal programme is in place and staff confirmed they are receiving supervision. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and in the best interest of the people who live there. The health, safety and welfare of the service users is promoted and protected. Evidence: The manager of the home was on annual leave when we did the inspection. He became registered manager of the service in August this year. The interview he had with the commission shows he has skills and experience to run the home. Staff spoke positively about the leadership and management approach of the home The service has effective quality assurance and monitoring systems. They told us they have a quality assurance audit files, which include audits in medication, finances, health action and health and safety. Questionnaires have been sent to service users , care managers, relatives and staff in the spring. The results of these questionnaires are being collated. The information needs to be returned to the home so they can start taking steps to improve the service offered to the people who live at Cosy Lodge. The results of the survey need to be published and made available. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The Area Manager visits the home every month to carry out Regulation 26 visits. All of the necessary Health and Safety checks have been carried out in the home. A fire assessment has been done. This does need to be reviewed to make sure that it is up to date and reflects the present situation in the home. Fire checks and drills are done at the necessary intervals. Water temperatures are taken and comply with regulations. The service is aware of reporting incidences to the Commission under Regulation 37. Containment of Substances Hazardous to Health (COSHH) products are locked away safely and regular audits are done. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 All plans need to be up dated to reflect the changing needs of the service users. All parts of the plan need to be individualised. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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